Cancer develops when cells in a part of the body begin to grow out of control. Although there are many kinds of cancer, they all start because of out-of-control growth of abnormal cells. Cancer develops when cells in a part of the body begin to grow out of control. Although there are many kinds of cancer, they all start because of out-of-control growth of abnormal cells. Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person’s life, normal cells divide more rapidly until the person becomes an adult. After that, cells in most parts of the body divide only to replace worn-out dying cells and to repair injuries. Because cancer cells continue to grow and divide, they are different from normal cells. Instead of dying, they outlive normal cells and continue to form new abnormal cells. Cancer cells often travel to other parts of the body where they begin to grow and replace normal tissue. This process, called metastasis, occurs as the cancer cells get into the bloodstream or lymph vessels of our body. When cells from a cancer like breast cancer spread to another organ like the liver, the cancer is still called breast cancer, not liver cancer. Cancer cells develop because of damage to DNA. This substance is in every cell and directs all its activities. Most of the time when DNA becomes damaged the body is able to repair it. In cancer cells, the damaged DNA is not repaired. People can inherit damaged DNA, which accounts for inherited cancers. Many times though, a person’s DNA becomes damaged by exposure to something in the environment, like smoking. Cancer usually forms as a tumor. Some cancers, like leukemia, do not form tumors. Instead, these cancer cells involve the blood and blood-forming organs and circulate through other tissues where they grow. Remember that not all tumors are cancerous. Benign (noncancerous) tumors do not spread to other parts of the body (metastasize) and, with very rare exceptions, are not life threatening. Different types of cancer can behave very differently. For example, lung cancer and breast cancer are very different diseases. They grow at different rates and respond to different treatments. That is why people with cancer need treatment that is aimed at their particular kind of cancer. Cancer is the second leading cause of death in the United States. Half of all men and one-third of all women in the US will develop cancer during their lifetimes. Today, millions of people are living with cancer or have had cancer. The risk of developing most types of cancer can be reduced by changes in a person’s lifestyle, for example, by quitting smoking and eating a better diet. The sooner a cancer is found and treatment begins, the better are the chances for living for many years.
Women age 20 and older should examine their breast monthly for lumps or other signs of cancer using a reliable method such as the one described below. Once you learn how to do a thorough breast self-exam, it takes only a minute or two each month. Women should also get a clinical breast exam from a health professional every three years, and an annual mammogram after age 40 to help detect breast cancer early when it is more easily treated. The best time for breast self examination (BSE) is about a week after your period ends, when your breasts are not tender or swollen. If you are not having regular periods, do BSE on the same day every month. Lie down with a pillow under your right shoulder and place your right arm behind your head. Use the finger pads of the three middle fingers on your left hand to feel for lumps in the right breast. Press firmly enough to know how your breast feels. A firm ridge in the lower curve of each breast is normal. If you’re not sure how hard to press, talk with your doctor or nurse. Move around the breast in a circular, up and down line, or wedge pattern. Be sure to do it the same way every time, check the entire breast area, and remember how your breast feels from month to month. Repeat the exam on your left breast, using the finger pads of the right hand. (Move the pillow to under your left shoulder) If you find any changes, see your doctor right away. Repeat the examination of both breasts while standing, with your arm behind your head. The upright position makes it easier to check the upper and outer part of the breasts (toward your armpit). This is where about half of breast cancers are found. You may want to do the standing part of the BSE while you are in the shower. Some breast changed can be felt more easily when your skin is wet and soapy. For added safety, you can check your breasts for any dimpling of the skin, changes in the nipple, redness, or swelling while standing in front of the mirror right after your BSE each month.
It is important for you to have frank, open discussions with your cancer care team. Don’t be afraid to ask questions, no matter how trivial you might think they are. Some questions to consider: What type of breast cancer do I have? Has my cancer spread to lymph nodes or internal orgasm? What is the stage of my cancer and how does it affect my treatment options and prognosis? Am I eligible for any clinical trials? What treatments are appropriate for me? What do you recommend? Why? What are the risks or side effects that I should expect? How effective will breast reconstruction surgery be if I need or want it? What should I do to get ready for treatment? Should I follow a special diet? Will I be able to have children after my treatment? What are the chances my cancer will come back with the treatment programs we have discussed? Will I go through menopause as a result of the treatment? Will I have normal sensation in my breasts after my treatment? Be sure to write down any questions that occur to you that are not on this list. For instance, you might want specific information about anticipated recovery times so you can plan your work schedule. Or, you may want to ask about second opinions or about clinical trials for which you may qualify. Taking another person and/or a tape recorder to the appointment can be helpful. Collecting copies of your medical records, pathology reports and radiology reports may be useful in case you wish to seek a second opinion at a later time.
The Good News about Breast Cancer These cutting-edge tests and treatments will help more women than ever beat the disease By Sharlene K. Johnson (Ladies' Home Journal - October 2002) Exciting advances in breast cancer diagnostics and treatment may one day make standard mammograms, surgery and radiation obsolete. SALIVA TEST In a preliminary study, researchers measured saliva levels of HER2, a protein that is elevated in some breast-cancer cases. They were able to identify 87 percent of those with the disease. Status: Not yet available. The company that developed the saliva test hopes to apply for FDA approval by the end of 2003. DIGITAL_ MAMMOGRAPHY Recent reports show that a mammogram is only as good as the duality of the scan and the skill of the person reading it. Digital mammograms, unlike X-ray film, can be manipulated to improve brightness and contrast. They can also he combined with computer aided detection systems as a way to help flag suspicious areas in the breast. COMPUTERIZED THERMAL IMAGING A heat-sensitive camera captures thermal images of the breast, which can he analyzed to help doctors decide if a suspect area should be biopsied. The technique is based on slight temperature variations between benign and malignant lesions. Status: It's currently under FDA review and available only to patients in clinical studies. DUCTAL LAVAGE Most breast cancers are believed to begin in the milk ducts. Ductal lavage involves inserting a tiny catheter through the nipple into a milk duct to wash out cells and collect them for testing. This test can help doctors evaluate an individual's personal risk and make decisions about preventive treatment. Status: Available to high-risk women at more than 100 clinics in the U.S. IMAGE-GUIDED BIOPSIES Non-surgical biopsies make recovery easier for patients whose results are benign. In core needle biopsies or in vacuum-assisted biopsies, doctors can use X rays (in a procedure: called a stereotactic biopsy) or ultrasound to guide the sampling device. Status: Minimally invasive biopsy techniques have been widely available for several years, but many women are still being sent to the operating room for an open surgical biopsy. TUMOR ABLATION Performed through tiny incisions, ablation may someday substitute for traditional invasive surgery. Doctors insert a probe into the tumor and destroy it with extreme temperatures, either cold (cryoahlation) or heat (radiofrequency ablation). Status: Ablation techniques for cancerous breast tumors are in clinical trials now. AROMATASE INHIBITORS This relatively new class of drags - including anastro:ole, exemestane and letroole - inhibit the development of estrogen, which some tumors need to thrive. Studies show that these drugs may prevent breast cancer even more effectively than tamoxifen. Status: Currently, aromatase inhibitors are prescribed only to post menopausal women who already have advanced breast cancer, though studies are under way to see if they also may play a larger role in preventing breast cancer in earlier stages. TARGETED RADIATION Standard radiation treatment risks exposing healthy tissue to unnecessary radiation. In one of the newest versions of targeted internal radiation, or brachytherapy, doctors insert a small balloon filled with saline inside the surgical cavity after a lurnpectotny. A tiny radioactive bead in the balloon delivers a measured dose of radiation only to the tissue immediately surrounding the site of the tumor for five days of treatments. Status: The FDA approved the Mamtno.Site balloon system in May 2002, although it is not yet known if it will prove to he as effective as traditional radiation treatments.
Key Statistics for Breast Cancer Breast cancer is the most common cancer among women, excluding nonmelanoma skin cancers. The American Cancer Society estimates that in 2002 about 203,500 new cases of invasive breast cancer (Stages MV) will be diagnosed among women in the United States. In situ breast cancer accounts for about 54,300 new cases each year. In situ (Stage 0) is noninvasive and is the earliest form of breast cancer. Breast cancer also occurs in men. An estimated 1,500 cases will he diagnosed among men. The breast cancer incidence rare, a measure of the number of new breast cancers per 100,000 women, increased by about 4.5% per year during the 1980s. During the 1990s, the incidence leveled off to 110.6 cases per 100,000 women. In 2002 there will be about 40,000 deaths from breast cancer in the United States (39,600 among women, and 400 among men). Breast cancer is the second leading cause of cancer death in women, exceeded only by lung cancer. Death rates from breast cancer declined significantly during 1992 to 1998, with the largest decreases in younger women-both white and black. These decreases are probably the result of earlier detection and improved treatment. 8 Tips for good mammograms 1 Ask to see the FDA certificate that is issued to all facilities that meet high professional standards of safety and quality. 2-Use a facility that either specializes in mammography or performs many mammograms a day. 3-If you are satisfied that the facility is of high quality, continue to go there on a regular basis so that your mammograms can he compared from year to year. 4-If you change facilities, ask for your old mammograms to bring with you to the new facility so that they can he compared to the new ones. 5-If you have sensitive breasts; try having your mammogram at a time of the month when your breasts will be least tender. Try to avoid the week right before your period. This will help to lessen discomfort. 6-Don't wear deodorant, powder or cream, under your ;firms - it may interfere with the quality of the mammogram. 7-bring a list of the places, dates of mammograms, biopsies, or other breast treatments you have had before. 8-If you do not hear from your physician within 10 days, do not assume that your mammogram was normal - confirm this by calling your physician or the facility. For more information, call toll free 1-800-ACS-2345 or on the Internet www.cancer.org.
What is breast cancer? Breast cancer is a malignant tumor that has developed from cells of the breast. The disease occurs mostly in women, but does occur rarely in men. The remainder of this document refers only to breast cancer in women. A separate document on male breast cancer is also available from the American Cancer Society. NORMAL BREAST STRUCTURE - The main components of the female breast are lobules (milk-producing glands), ducts (milk passages that connect the lobules and the nipple), and stroma (fatty tissue and ligaments surrounding the ducts and lobules, blood vessels, and lymphatic vessels). Lymphatic vessels are similar to veins, except that they carry lymph instead of blood. Lymph is a clear fluid that contains tissue waste products and immune system cells. Cancer cells can enter lymph vessels. Most lymphatic vessels of the breast lead to axillary (underarm) lymph nodes. Lymph nodes are small bean-shaped collections of immune system cells that are important in fighting infections. When breast cancer cells reach the axillary lymph nodes, they can continue to grow, often causing swelling of the lymph nodes in the underarm area. If breast cancer cells have grown in the axillary lymph nodes, they are more likely to have spread to other organs of the body as well. This is why finding out whether breast cancer has spread to axillary lymph nodes is important in selecting the best mode of treatment. BENIGN BREAST LUMPS - Most breast lumps are benign, that is, not cancerous. Most lumps are caused by fibrocystic changes. Cysts are fluid-filled sacs, and fibrosis refers to connective tissue or scar tissue formation. Breast swelling and pain can be caused by fibrocystic changes. The breasts may feel nodular, or lumpy, and, sometimes, a clear or slightly cloudy nipple discharge is present. Benign breast tumors such as fibroadenomas or papillomas are abnormal growths, but they cannot spread outside of the breast to other organs. They are not life-threatening. For more information, refer to the American Cancer Society document on "Benign Breast Conditions." TYPES OF BREAST CANCERS - Understanding some of the key words used to describe different types of breast cancer is important because these types vary in their prognosis (the outlook for chances of survival) and their treatment options. An alphabetical list of terms, including the most common types of breast cancer, is given below: ADFNOCARCINOMA: This is a general type of cancer that starts in glandular tissues anywhere in the body. Nearly all breast cancers start in glandular tissue Of the breast and, therefore, are adenocarcinotnas. The two main types of breast adenocarcinonnas are ductal carcinomas and lobular carcinomas. DUCTAL CARCINOMA IN SITU(DCIS): Ductal carcinoma in situ (also known as intraductal carcinoma) is the most common type of noninvasive breast cancer. There are cancer cells inside the ducts but they have not spread through the walls of the ducts into the fatty tissue Of the breast. Nearly 100% of women diagnosed at this early stage of breast cancer can be cured. The best way to find DCIS is with a mammogram. With more women getting tnatntnogratus each year, a diagnosis of DCIS is becoming more common. DCIS is sometimes Subclassified based on its grade and type, in order to help predict the risk of cancer returning after treatment and to help select the most appropriate treatment. Grade refers to how aggressive cancer cells appear under a microscope. There are several types of DCIS, but the most important distinction among them is whether or not tumor cell necrosis (areas of dead or degenerating cancer cells) is present. The term comelocarcinotna is often used to describe a type of IVIS %with necrosis. INFILTRATING (OR INVASIVE) DUCTAL CARCINOMA (IDC): Starting in a milk passage, or duct, of the breast, this cancer has broken through the wall of the duct and invades the fatty tissue of the breast. At this point, it has the potential to metastasize, or spread, to Other parts of the body through the lymphatic system and bloodstream. Infiltrating ductal carcinoma accounts for about 80%) of invasive breast cancers. INFLAMMATORY BREAST CANCER: This rare type of invasive breast cancer accounts for about 1% of all breast cancers. Inflammatory breast cancer makes the skin of the breast look red and feel warm, as if it was infected and inflamed. The skin has a thick, pitted appearance that doctors often describe as resembling an orange peel. Sometimes the skin develops ridges and small bumps that look like hives. Doctors now know that these changes are not due to inflammation or infection, but the name given to this type of cancer long ago still persists. Cancer cells blocking lymph vessels or channels in the skin over the breast cause these symptoms. IN SITU: This term is used for an early stage of cancer in which it is confined to the immediate area where it began. Specifically in breast cancer, in situ means that the cancer remains confined to ducts (ductal carcinoma in situ) or lobules (lobular carcinoma in situ). It has not invaded surrounding fatty tissues in the breast nor spread to other organs in the body. LOBULAR CARCINOMA IN SITU (LCIS): While not a true cancer, LCIS (also called lobular neoplasia) is sometimes classified as a type of noninvasive breast cancer. It begins in the milk-producing glands, but does not penetrate through the wall of the lobules. h'lost breast cancer specialists think that I-CIS, itself, does not become an invasive cancer, but women with this condition do have a higher risk of developing an invasive breast cancer in the same breast, or in the opposite breast. For this reason, its important for women with LCIS to have a physical exam two or three times a year, as well as an annual manunogram. MEDULLARY CARCINOMA: This special type of infiltrating breast cancer has a relatively well defined, distinct boundary between tumor tissue and normal tissue. It also has some other special features, including the large size of the cancer cells and the presence of immune system cells at the edges of the tumor. Medullary carcinoma accounts for about 5% of breast cancers. The outlook, or prognosis, for this kind of breast cancer is better than for other types of invasive breast cancer. MUCINOUS CARCINOMA: This rare type of invasive breast cancer is formed by mucus-producing cancer cells. The prognosis for mucinous carcinoma is better than for the more common types of invasive breast cancer. Colloid carcinoma is another name for this type of breast cancer. PAGET'S DISEASE OF THE NIPPLE: This type of breast cancer starts in the breast ducts and spreads to the skin of the nipple and then to the areola, the dark circle around the nipple. It is a rare type of breast cancer, occurring in only 1°^0 of all cases. The skin of the nipple and areola often appears crusted, scaly, and red, with areas of bleeding or oozing. The woman may notice burning or itching. Paget's disease may be associated with in situ carcinoma, or with infiltrating breast carcinoma. If no lump can be felt in the breast tissue, and the biopsy shows DCIS but no invasive cancer, the prognosis is excellent. PHYLLODES TUNIOR: This very rare type of breast tumor forms from the stroma (connective tissue) of the breast, in contrast to carcinomas which develop in the ducts or lobules. Phyllodes (also spelled phylloides) tumors are usually benign but on rare occasions may be malignant (having the potential to metastasize). Benign phyllodes tumors are successfully treated by removing the mass and a narrow margin of normal breast tissue. A malignant phyllodes tumor is treated by removing it along with. i wider margin of normal tissue, or by mastectomy. These cancers do not respond to hormonal thrr,ipy and are not so likely to respond to chemotherapy or radiation therapy. In the past, both benign and malignant phyllodes tumors were referred to as cystosarcotna phyllodes. TUBULAR CARCINOMA: Accounting for about Z" o of all breast cancers, tubular carcinomas are a special type of infiltrating breast carcinoma. They have a better prognosis than usual infiltrating ductal or lobular carcinomas.
What is Reflexology
Reflexology is a science which deals with the principle that there are reflexes in the feet relative to each organ and all parts of the body. Stimulating these reflexes properly can help many health problems in a natural way. Not to be compared to massage, Reflexology uses the pressure points on the feet and hands to relax each part of the body. There are 7,200 nerve endings on each foot, so a reflexology treatment relaxes the stress that can affect your health. The practice of Reflexology dates back to the Egyptian culture, 2330 B.C. The Chinese have used Reflexology for centuries, combined with Acupuncture for health and well-being. Treatments usually take 30 minutes to an hour. I have been giving treatments to women with breast cancer for six years. What we have discovered is this. The body holds toxins in all parts of the body. When a patient is receiving chemical treatments for her cancer she is taking on all the toxins that chemical provides to help rid her body of the cancer. When she receives reflexology, massage, acupuncture and colonics she is assisting her body in eliminating the toxins from her body. Ten to twelve glasses of water is a must with these alternative health practices. Paula Miller, Reflexologist 816-781-7614
What's all the talk about vitamin E, and almonds?
Well, word is, almonds are a leading natural food source of this powerful antioxidant. In fact, just two ounces of tasty almonds a day provides 100% of your RDA of vitamin E Plus, they're low in saturated fat and cholesterol free
Personal Resources and Strategies
Get in touch with your values. Think about what you want from life for yourself and your family. How does a career fit into that? Is the work you do important for your sense of self, or is it only for the money? Is your work meaningful? Set priorities. Decide, based on your values, what tasks are important and which are less important. It’s all about choices. At home, today’s choice may be making dinner with your kids and enjoying the feast together. The laundry can probably wait until tomorrow. At work, don’t stay late tonight. What will happen if you wait until tomorrow to tackle that new project, with a fresh perspective? Review your priorities every month. Ask yourself whether you are accomplishing your goals. Take time to shift from work to family. It usually takes 15 to 20 minutes to shift gears from work to family. Use time on the way home to clear your head. Try making tomorrow’s “to do” list at the close of the workday. Listen to music you enjoy as you travel. Use the drive home to forget about work and concentrate on family. Try to avoid brining work home. Once home, take a 15-minute break to change clothes, wash your face, freshen your lipstick and your outlook! Take care of your physical health. This makes you better able to withstand emotional and physical stress. This means: Get regular checkups, Eat a healthy diet, and Exercise regularly. Plan and work efficiently. Use schedules for planning for family, work and other activities. Make the most of the time spent together with your family. Work together to accomplish tasks around the house. For example, by doing the dishes with a family member, you’ll get a job done and spend time together. SOLUTION Be realistic. Work-family stress is likely to be greater if there is a wide gap between what you expect of yourself and what you achieve. For most of us, there is always more to do than time available. Discover what you can do. This doesn’t mean sacrificing your dreams. It means developing realistic expectations of yourself. Do you run out of week before you run out of work? If you have 10 things on your to-do list, take a second look. Determine what you can accomplish and what will have to wait. Then, take a break and renew your spirits. Return to tackle the first task with a fresh perspective.
Put yourself in the picture of control. Take charge of life!
Spend a few minutes at the beginning of each week, outside of your normal routine or morning rush, to plan each week. Then communicate to everyone involved what will happen each day. A family calendar displayed for all to see is a good choice for many. Plan Ahead Prioritize activities Schedule time Maintain nutrition, exercise, sleep Budget money Work together Encourage cooperation Promote self-reliance Communicate Forgive and forget Enjoy time together Relax, allow for humor Engage brain before operating mouth Plan fun times to liven routine Celebrate special occasions
Managing your household
1. Identify your priorities: 2. Set Goals 3. Schedule 4. Delegate 5. Have a laundry basket available for each member of the family 6. Plan means 7. Plan the night before the following day 8. Clean and pick up as you go 9. Do two things at once 10. Take charge and feel good
Caregiving: A different kind of job
The 21st century will be marked by a dramatic increase in the size of the older population as the baby boom generation ages. An increase in older adults will mark a corresponding increase in demanding illnesses such as Alzheimer’s disease, Parkinson’s disease and stroke. These disorders affect not only the individual, but can also be devastating to the family. Already, millions of working adults are juggling the competing demands of caring for a chronically ill or disabled parent, raising a family, and managing a career.